Associations between rural hospital closures and acute and post-acute care access and outcomes.

Objective: To determine whether rural hospital closures affected hospital and post-acute care (PAC) use and outcomes.

Study Setting And Design: Using a staggered difference-in-differences design, we evaluated associations between 32 rural hospital closures and changes in county-level: (1) travel distances to and lengths of stay at hospitals; (2) functional limitations at and time from hospital discharge to start of PAC episode; (3) 30-day readmissions and mortality and hospitalizations for a fall-related injury; and (4) population-level hospitalization and death rates.

Data Sources And Analytic Sample: 100% Medicare claims and home health and skilled nursing facility clinical data to identify approximately 3 million discharges for older fee-for-service Medicare beneficiaries.

Single-Nucleus Atlas of Cell-Type Specific Genetic Regulation in the Human Brain.

Genetic risk variants for common diseases are predominantly located in non-coding regulatory regions and modulate gene expression. Although bulk tissue studies have elucidated shared mechanisms of regulatory and disease-associated genetics, the cellular specificity of these mechanisms remains largely unexplored. This study presents a comprehensive single-nucleus multi-ancestry atlas of genetic regulation of gene expression in the human prefrontal cortex, comprising 5.

Plasticity of Human Microglia and Brain Perivascular Macrophages in Aging and Alzheimer's Disease.

The complex roles of myeloid cells, including microglia and perivascular macrophages, are central to the neurobiology of Alzheimer's disease (AD), yet they remain incompletely understood. Here, we profiled 832,505 human myeloid cells from the prefrontal cortex of 1,607 unique donors covering the human lifespan and varying degrees of AD neuropathology. We delineated 13 transcriptionally distinct myeloid subtypes organized into 6 subclasses and identified AD-associated adaptive changes in myeloid cells over aging and disease progression.

Neuropsychiatric polygenic scores are weak predictors of professional categories.

Polygenic scores (PGS) enable the exploration of pleiotropic effects and genomic dissection of complex traits. Here, in 421,889 individuals with European ancestry from the Million Veteran Program and UK Biobank, we examine how PGS of 17 neuropsychiatric traits are related to membership in 22 broad professional categories. Overall, we find statistically significant but weak (the highest odds ratio is 1.

Microresonator photonic wire bond integration for Kerr-microcomb generation.

Extremely high-Q microresonators provide an attractive platform for a plethora of photonic applications including optical frequency combs, high-precision metrology, telecommunication, microwave generation, narrow linewidth lasers, and stable frequency references. Moreover, the desire for compactness and a low power threshold for nonlinear phenomena have spurred investigation into integrated and scalable solutions. Historically, crystalline microresonators with Q ∼ 10 were one of the first material platforms providing unprecedented optical performance in a small form factor.